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Biomedical subjects

P A Freeman

Publications and source records attributed to P A Freeman.

At least 19 recordsLinked to original sources

Motivational effects of ethanol in DARPP-32 knock-out mice.

DARPP-32 (dopamine and adenosine 3',5'-monophosphate-regulated phosphoprotein, 32 kDa) is an important component of dopaminergic function in brain areas thought to be important for drug and alcohol addiction. The present experiments characterized the acquisition of ethanol-induced conditioned taste aversion, ethanol-induced conditioned place preference, and ethanol self-administration in DARPP-32 knock-out (KO) mice compared to wild-type (WT) controls. For taste conditioning, KO and WT mice received access to 0.2 m NaCl solution followed immediately by intraperitoneal injection of 0-4 gm/kg ethanol. Ethanol produced dose-dependent conditioned taste aversion that was the same in both genotypes. For place conditioning, KO and WT mice received eight pairings of a tactile stimulus with ethanol (2 gm/kg, i.p.), and a different stimulus with saline. Ethanol produced increases in locomotor activity during conditioning, with KO mice showing higher activity levels after ethanol compared to WT mice. WT mice, but not KO mice, acquired conditioned preference for the ethanol-paired stimulus. In the self-administration procedure, KO and WT mice were trained to lever press for access to 10% v/v ethanol. Subsequently, the mice had 23 hr/d access to food, ethanol, and water. Response patterns were determined using 0-30% v/v ethanol concentrations. WT mice displayed concentration-dependent responding for ethanol. Responding on the ethanol lever by KO mice did not change as a function of ethanol concentration. Saccharin (0.2% w/v) was subsequently added to the ethanol mixture, and responding was examined at 0, 5, 10, and 20% ethanol concentrations. Ethanol responding increased in both genotypes, although WT mice showed higher rates at all concentrations.

Animals↗

Lack of operant ethanol self-administration in dopamine D2 receptor knockout mice.

RATIONALE: Dopamine D2 receptors are postulated to play an important role in modulating the reinforcing effects of abused drugs including ethanol. OBJECTIVES: This experiment examined operant ethanol self-administration in dopamine D2 receptor knockout (KO) mice and wild-type (WT) mice using a continuous access procedure. METHODS: Adult male KO and WT mice were trained in 30-min sessions to perform a lever press response for access to 10% v/v ethanol. After training, the mice were placed in test chambers on a continuous (23 h/day) basis with access to food (one lever press, i.e., FR1), 10% v/v ethanol (four lever presses, i.e., FR4), and water from a sipper tube (phase 1). After 30 consecutive sessions, response patterns were determined for 0, 5, 10, 20 and 30% v/v ethanol (phase 2). Saccharin (0.2% w/v) was subsequently added to the ethanol mixture and responding was examined for 0, 5, 10 and 20% ethanol (phase 3). RESULTS: During phase 1, WT mice displayed higher ethanol-lever responding compared to KO mice. Food lever responding and water intake was the same in both genotypes. During phase 2, WT mice displayed concentration-dependent ethanol lever responding, whereas KO mice responded at low rates regardless of ethanol concentration. WT mice also responded more for food compared to KO mice. Each genotype showed similar water intakes except at the 20% ethanol concentration, where WT mice had lower intakes. During phase 3, WT mice continued to show higher responding for all concentrations including saccharin alone. WT mice also continued to respond more for food compared to KO mice, but drank less water. In each phase, WT mice displayed episodic (bout) responding on the ethanol lever. KO mice did not respond for ethanol in bouts. CONCLUSIONS: Reduced responding in the KO mice for several reinforcers including ethanol indicates a more general role for dopamine D2 receptors in motivated responding rather than a specific role in ethanol reinforcement.

Animals↗

Clozapine's effects on ethanol's motivational properties.

BACKGROUND: Although dopamine D1 and D2 receptors have been implicated in ethanol's motivational effects, little is known about the contribution of dopamine D4 receptors. The present experiments examined the effects of clozapine, a dopamine D4 receptor antagonist, on ethanol's aversive, rewarding, stimulant, and reinforcing properties. METHODS: For taste conditioning, adult male Swiss-Webster mice received five conditioning trials consisting of 1-hr access to 0.2 M NaCl. After NaCl access on trials 1-4, subjects received clozapine (0, 1, or 2 mg/kg) followed 30 min later by 0, 2, or 4 g/kg ethanol. For place conditioning, Swiss-Webster mice received six pairings of a tactile stimulus with ethanol (2 g/kg, intraperitoneally), clozapine (1 mg/kg, intraperitoneally) + ethanol, or clozapine alone. Locomotor activity in a 30-min test was determined in Swiss-Webster mice receiving 0, 0.5, or 1.0 mg/kg clozapine and 0, 1, or 2 g/kg ethanol. In a drinking study, separate groups of adult male C57BL/6J mice were allowed 30-min access to either 10% v/v ethanol mixed in 10% w/v sucrose or 10% sucrose without ethanol. During testing, both groups were given 0 or 1 mg/kg clozapine 30 min before fluid access. RESULTS: Ethanol flavor pairings during taste conditioning reduced subsequent flavor intakes, indicating the development of conditioned taste aversion. Clozapine reduced the magnitude of 4 g/kg ethanol-conditioned aversion only on trial 4 at the 2 mg/kg dose. Conditioned place preference for the ethanol-paired stimulus was not altered by clozapine. Clozapine alone did not produce either conditioned preference or aversion. Ethanol-stimulated activity was reduced by clozapine treatment. However, clozapine alone did not alter locomotor activity levels. Clozapine reduced sucrose consumption but did not alter ethanol/sucrose intake. CONCLUSIONS: These data suggest that clozapine influences a limited range of ethanol-motivated behaviors. Specifically, dopamine D4 receptors appear important for ethanol's stimulant effect and possibly ethanol aversion, but not ethanol reward and reinforcement.

Alcohol Drinking↗

Factors affecting the use of immunization among urban settlement dwellers in Papua New Guinea.

This paper examines the importance of selected social factors in the acceptance of childhood immunization in urban settlements in Port Moresby, Papua New Guinea. The study found that the provision of information to mothers on when to start immunization and how often the child should be immunized were key factors in determining immunization status. Maternal education was found to be positively associated with knowledge of immunization, but was not significantly associated with actual immunization practice. Over 70% of the women studied found out when to attend for immunization from the local maternal and child health (MCH) staff, hence emphasizing their importance in disseminating information. If coverage is to be increased further in urban settlements with mobile populations, maximal use must be made of local community organizations to disseminate the key immunization information and for follow-up of newborns and infants new to the community. Efforts to encourage mothers to deliver under supervision should also continue as this is an important point of first contact for immunization.

Child, Preschool↗

Possible reasons for non-completion of immunization in an urban settlement of Papua New Guinea.

A study to identify possible reasons for non-completion of immunization among children was carried out in an urban settlement of Port Moresby. It was found that the children's mothers lacked basic understanding about immunization and the potential seriousness of immunizable diseases. There was also poor social interaction between health workers and the mothers. It is recommended that emphasis be placed also on the social aspects of immunization if widespread coverage is to be achieved.

Attitude of Health Personnel↗

Comprehensive waste regulation dumped. A limited demonstration project is all that remains.

When medical wastes started washing up along the Eastern Seaboard and the shores of the Great Lakes in 1988, healthcare providers became subject to close public scrutiny. Not only was the situation deplorable; the solution, they feared, would keep them entangled in red tape for years. Public outcry sent members of Congress scurrying to legislate medical waste regulation. But what many had predicted would be a comprehensive, nationwide regulation that tracked medical waste from cradle to grave turned out to be a demonstration project limited to Puerto Rico and four states in the Northeast. The Medical Waste Tracking Act of 1988 went into effect in June 1989. When it expires in June 1991, the Environmental Protection Agency (EPA) will report to Congress on the program's impact, presumably with an eye toward whether further legislation and continuing regulations are necessary. In the meantime, participating states must establish a system of tracking medical waste from its point of generation to its disposal by either incineration or burial in a landfill. Medical waste generators must separate it from other kinds of waste and place it in special labeled containers. They must also prepare a tracking form that accompanies the cargo and requires sign-off by generator, transporter, and disposal facility operator. The EPA has legal access to medical waste tracking forms and can inspect any site where medical wastes are located. Violators are subject to stiff civil and criminal penalties.

Facility Regulation and Control↗

Lower limb fractures in the chronic spinal cord injured patient.

Experience in managing 33 lower limb fractures in 25 chronic spinal injured patients is described. An increased awareness among patients and medical staff is required to avoid misdiagnosis. Effort should be made to ensure bone union in satisfactory position, recognising the different requirements of ambulant and non-ambulant patients. 'Soft pillow splints' were found to give the best results in all fractures other than those of the femoral neck. Operative treatment with antibiotic prophylaxis is only indicated to correct important deformity.

Adolescent↗

Hybrid FES orthosis incorporating closed loop control and sensory feedback.

A hybrid functional electrical stimulation (FES) orthosis is described, comprising a rigid ankle-foot brace, a multi-channel FES stimulator with surface electrodes, body mounted sensors, a 'rule-based' controller and an electro-cutaneous display for supplementary sensory feedback. The mechanical brace provides stability, without FES activation of muscles, for standing postures normally adopted by patients. This avoids inducing muscle fatigue during prolonged upright activity. However, stability is conditional upon the position of the ground reaction vector (GRV) relative to the knee joint. The finite state FES controller reacts automatically to destabilizing shifts of the GRV by stimulating appropriate anti-gravity musculature to brace the leg. The FES system also features a control mode to initiate and terminate flexion of the leg during forward progression. A simple mode of supplementary sensory feedback was used during the laboratory standing tests to assist the patient in maintaining a set posture. Preliminary results of laboratory tests for two spinal cord injured subjects are presented.

Adult↗

Augmentation of the Oswestry Parawalker orthosis by means of surface electrical stimulation: gait analysis of three patients.

The Oswestry 'Parawalker' orthosis has been supplied to 15 adult thoracic level complete paraplegic patients enabling them to achieve a reciprocal gait with an inherent low energy demand. In order to further off-load the work demands on the upper limb girdle musculature during ambulation, three of these patients have undergone electrical stimulation of the gluteal muscles in stance phase. This was shown to increase the stability of the adduction and also provided forward propulsion by driving the stance-leg into extension. Bilateral stimulation of the quadriceps muscles has been shown to facilitate standing and sitting in the orthosis. Using a Kistler force platform, the crutch impulse can be seen to be reduced by as much as 36%. We speculate that this leads to a similar order of reduction in the work done by the upper limbs in these patients.

Adult↗

Surgical stabilisation of the rheumatoid cervical spine. A review of indications and results.

We have reviewed 32 patients with rheumatoid disease of the cervical spine who underwent a total of 40 operations aimed at correcting instability and improving any associated neurovascular deficit. Apart from four patients with intractable pain, the main indication for surgery was progressive neurological impairment. Of the 32 primary operations, 19 (60%) were successful; the remainder failed to achieve their objective and there were two deaths in the immediate postoperative period. Of eight secondary operations performed for recurrence of symptoms or failure to relieve cervical myelopathy, only four were successful. Of nine operations for bony decompression to relieve cord compression from irreducible subluxation, only four were successful. The overall results show a success rate of 57% and a failure rate of 35% with early operative mortality in 8%. Indications for operation are discussed and earlier diagnosis is considered to be the key to improved results.

Aged↗

The long-term results of the Howse total hip arthroplasty. With particular reference to those requiring revision.

We present the results of 506 consecutive Howse hip arthroplasties with a minimum follow-up of 10 years. The mortality within one month of surgery was 0.79%. The early dislocation rate was 1.38%, two hips requiring revision. Nine hips developed deep sepsis (1.78%), eight of which required revision. At 10 years 42 hips (8.3%) had required revision, including 14 with aseptic acetabular loosening and 11 with femoral stem fractures. We feel that as judged by the dislocation rate and the need for subsequent revision, the Howse arthroplasty is an acceptable form of total hip replacement, particularly in the older patient and in those requiring total replacement for femoral neck fractures.

Adult↗

Bilateral hip and knee replacement in rheumatoid arthritis.

A series of 20 patients who had bilateral hip and knee replacement are reviewed and analyzed. Early surgical opinion should be sought before all four joints are irreparably destroyed and the patient is nonambulant so that the joints can be replaced one at a time, as necessary to maintain mobility. This considerably reduces stress to the patient, the surgeon, the nursing staff, and the rehabilitation team. The follow-up period ranged from 2 to 13 years. The early postoperative complications were few and the reoperation rate for aseptic loosening in this study was 3.75%.

Aged↗

Total knee arthroplasty in haemophilic arthritis.

The results of total knee replacement in five patients aged between 22 and 37 with severe haemophilia A or B are described. All patients had been managed conservatively without success. Frequent bleeds, severe pain and limitation of movement were the indications for operation. Despite close haematological surveillance, bleeding problems occurred in three of the patients and large quantities of plasma concentrates were required. Review of the patients over a period of 25 to 48 months after operation showed dramatic lessening of pain and maintenance of a satisfactory range of movement. The frequency of haemarthrosis diminished markedly and the requirements for factor concentrate in the years after operation fell substantially. Two patients returned to employment. Total knee replacement led to marked clinical improvement in all the patients, but the long-term results are not yet known.

Adult↗

Morphology of the gills of larval and parasitic adult sea lamprey, Petromyzon marinus L.

The general morphology of the gills is similar in larval (ammocoetes) and parasitic adult sea lampreys, Petromyzon marinus, despite different methods of ventilation necessitated by their feeding habits. The gill lamellae are supported by randomly-distributed pillar cells which enclose blood spaces and collagen columns. The distribution of these cells in lampreys is different from that of higher fishes and it may be inefficient for respiratory exchange. The presence of cytoplasmic microfilaments suggests that these cells have the ability to reduce the lamellar blood spaces through contraction. Marginal channels at the tips of the lamellae are lined only by endothelial cells. The thickness of the water-blood pathway in lampreys falls within the range described for higher fishes, with the most efficient gas exchange likely occuring at the lamellar tips where only a single layer of epithelial cells is present. The abrupt increase in height of the epithelium near the lamellar bases in adults, compared to the gradual transition in height along the lamellae in ammocoetes, is perhaps reflective of higher oxygen requirements during the parasitic stage. The consistent appearance of wide, lateral intercellular spaces within the respiratory epithelium of lampreys indicates possible involvement of these spaces in transport. Mucous secretion appears to be an important function of the superficial platelet cells in ammocoetes. "Mitochondria-rich" and "mitochondria-poor" superficial cells are observed in both ammocoetes and adults, with the mitochondria-rich cells more prevalent toward the lamellar bases. The possibility that at least some of these cells may be involved in absorption is discussed. Mitochondria-rich cells in the interlamellar region are morphologically different in ammocoetes and adults but all possess an abundance of smooth endoplasmic reticulum and hence resemble "chloride cells" of higher fishes. The similarity of these cells in the parasitic adult lamprey to chloride cells of marine fishes may reflect the potential of the adult lamprey to osmoregulate in salt water. A scarcity of these cells in ammocoetes and their resemblance to chloride cells in freshwater fishes may reflect the restriction of larval lampreys to a freshwater habitat.

Animals↗